Are systemic antibiotics necessary for the majority of new burn wounds?

No. The majority of early burn wounds can be treated with topical, antimicrobial agents because the risk of early burn wound infection is low. The goal is to prevent early colonization.

When should I worry about airway involvement with pediatric burn patients?

The anatomy of a child places them at higher risk for airway obstruction following a thermal injury. A child’s airway is relatively small; thus, less swelling is needed to cause a clinically significant airway obstruction. Practitioners or caregivers should be aware of these anatomical differences and the potential risk for airway compromise. Soot about the nose and mouth, carbonaceous sputum and facial involvement following a thermal injury should alert the physician or caregivers to potential future airway issues. The decision to intubate is based on good clinical judgment with the goal of securing an airway being an elective event versus emergent one.

FLUID RESUSCITATION

Pre-Hospital Fluids:

<5 years…………. 125 mL/hr

6-13 years………. 250 mL/hr

≥14 years……….. 500 mL/hr

Fluids in the Emergency Department:

2-4 mL Ringer’s Lactate x kg bodyweight x percent burn.

Give half over the first eight hours and remainder over next 16 hours.